PSA Level Up...

The final frontier. Deciding when, if and how.
NJ Fred
Posts: 46
Joined: Sun Mar 08, 2020 7:21 pm
Location: South Jersey & W. Palm Beach, FL

PSA Level Up...

Postby NJ Fred » Sun May 03, 2020 10:16 am

Gentlemen,

Asked my Urologist to do a PSA during my last visit re my AMS 700. Came back at 8.7. Repeated the blood test two weeks later and was 8.4. I will be undergoing a prostate biopsy asap.

My question is, have any of you had an elevated PSA following your implant? My GP tells me that the initial and any ongoing trauma following invasive surgery can have this effect. My procedure was done on 1/29/20.

I'm not getting my will in order or anything like that - - but to tell you I'm not on the edge of my office chair would be to lie to you. If I do have prostate cancer, I hope to be able to undergo radiation therapy. I have talked to several colleagues, three of whom had surgery and they advised me to avoid it unless it is the court of last resort.

Two others who did radiation reported far less trauma and side effect.

Guidance appreciated.

Fred
72 y/o, married 36 yrs to a lady with the patience of a Saint. Diabetic, high blood pressure - I'm a wreck! AMS 700 via Dr. Edward Becker, Palm Beach Urology, Wellington ,FL on 1/29/20.

Waynetho
Posts: 1768
Joined: Wed Nov 27, 2019 11:22 pm
Location: Dallas, TX

Re: PSA Level Up...

Postby Waynetho » Sun May 03, 2020 11:32 am

About 4-5 months before my surgery I had a catheter associated UTI that shot my temp up to 104 degrees. When I saw my urologist for the first time about a month later, my PSA was 7.5. He wanted to retest a month or two later but we kept forgetting.

It wasn't until my GP did a routine PSA in the tests during my quarterly exam in January that I knew that my PSA was back down below 1 (think it was 0.8). I had my GP send my URO the results because he was wanting me to get tested ASAP but I kept missing the lab on my way out of his office.
Last edited by Waynetho on Sun May 03, 2020 6:08 pm, edited 1 time in total.
62yo, married 41 yrs. Urolift (x4) 8/12/19. AMS 700CX 15cm (no RTE) penoscrotal 10/28/19, Frisco, TX. PD 1995/ED 2011. Cialis helped but hinged. (1995)L:6/G:5.5+, (2019)Pre-op L:5/G:4.5, (2/2020)L:6.0/G:5.0

NJ Fred
Posts: 46
Joined: Sun Mar 08, 2020 7:21 pm
Location: South Jersey & W. Palm Beach, FL

Re: PSA Level Up...

Postby NJ Fred » Sun May 03, 2020 11:45 am

waynethou,

Thank you, sir. My difficulties have been posted on this site several times so I will not be redundant. My bride is betting that's what drove my PSA up.

Nevertheless, I think the biopsy prudent.

Thank you again!

Fred
72 y/o, married 36 yrs to a lady with the patience of a Saint. Diabetic, high blood pressure - I'm a wreck! AMS 700 via Dr. Edward Becker, Palm Beach Urology, Wellington ,FL on 1/29/20.

tomas1
Posts: 1953
Joined: Tue Jul 23, 2013 5:12 pm
Location: Tempe, AZ

Re: PSA Level Up...

Postby tomas1 » Sun May 03, 2020 11:55 am

Fred, I think it's smart to get the biopsies.
Somehow, I don't think the implant caused the PSA spike.

My last PSA was about 5.2 and I scored 3-3 on the Gleason scale after the biopsies.
It would have been good to see the history of your PSA tests.
When mine started going up more quickly, my uro suspected cancer.

I think external beam radiation is what I'll do if the time comes.
My radiologist doesn't like using the radioactive seeds.

A good source of info is:
https://www.healingwell.com/community/default.aspx?f=35
85 years
Inject testosterone weekly.
Implant on 1/22/19 by Dr Avila.
Scrotal, hor. incision just over 1"
18cm AMS 700 CX, 3.5cm RTE 100cc res
Gleason 6 prostate cancer. Monitoring it for now.
Update: On my last biopsies the cancer wasn't found.

Whodat
Posts: 115
Joined: Thu Aug 08, 2019 11:21 pm

Re: PSA Level Up...

Postby Whodat » Sun May 03, 2020 12:07 pm

Good morning Fred,
At age 76 Had radiation and six months of hormone treatment with a Gleason score of seven and PSA of only 2.8. So far very little damage from radiation and almost total recovery. PSA now .02. My friends who had total prostate removal seemed to have much more adverse side effects than me.
Age 80 good health. Radiation prostate 28 hits 4 years ago with 6 months of horrible ADT. Good recovery and ED worse.
Can't tolerate oral drugs but 5 years of Alprostadil 40mcg/ml 25 units is a miracle for 3 hours. GF is happy!!

Whodat
Posts: 115
Joined: Thu Aug 08, 2019 11:21 pm

Re: PSA Level Up...

Postby Whodat » Sun May 03, 2020 12:09 pm

Fred,
My cancer was discovered by the digital exam not from PSA.
Age 80 good health. Radiation prostate 28 hits 4 years ago with 6 months of horrible ADT. Good recovery and ED worse.
Can't tolerate oral drugs but 5 years of Alprostadil 40mcg/ml 25 units is a miracle for 3 hours. GF is happy!!

Whodat
Posts: 115
Joined: Thu Aug 08, 2019 11:21 pm

Re: PSA Level Up...

Postby Whodat » Sun May 03, 2020 12:20 pm

Tomas,
A friend was diagnosed with Gleason 3+3 and was on active surveillance from a major cancer center.
A local doctor diagnosed him with Gleason 4+3 but he chose to go on active surveillance. At his next check up his cancer had spread out of the prostate. He chose to radiate but he will now be on the horrible hormone therapy for the rest of his life because of the spreading cancer in his whole body.
Age 80 good health. Radiation prostate 28 hits 4 years ago with 6 months of horrible ADT. Good recovery and ED worse.
Can't tolerate oral drugs but 5 years of Alprostadil 40mcg/ml 25 units is a miracle for 3 hours. GF is happy!!

Gordon
Posts: 155
Joined: Mon Dec 05, 2016 9:16 am
Location: Somewhere in Alabama

Re: PSA Level Up...

Postby Gordon » Sun May 03, 2020 1:24 pm

I would try radiation first. If you have the surgery you will no longer be able to ejaculate. I really miss that. I can have orgasims and really intense but nothing comes out. My PSA is doubling about every 8 months. Still very low but a cell must have escaped during surgery. I had radiation the year after the surgery also. Good luck with your decision.
Married 64
AMS LGX 700 2/15/2017

numansoon
Posts: 13
Joined: Wed Sep 11, 2019 10:39 am

Re: PSA Level Up...

Postby numansoon » Sun May 03, 2020 2:21 pm

Sorry to hear about your situation. There are lots of reasons for the PSA to be up. So first off don't panic, I agree that getting a biopsy makes sense at this point, but even that is not perfect. Remember that PC is usually very slow so you have time to access what is best for you. There simply is no one perfect solution. It was once described to me in golf terms. The ball will land in a different place for each person. It is a matter of deciding which club you need to play that particular shot.
Educate yourself on all the options. But bare in mind that modern outcomes for any of the options is very very good.

So it comes down to what you think is best for you. Once you decide don't second guess, it will drive you nuts.
I had mine at age 59 which is a bit young, and thus more likely to be a fast version. I was at a 5+4 yikes. Post op testing of tissue determined it was actually 3+4, still in the range of needing treatment.
I opted for robotic surgery. For me surgery was a better choice for a couple reasons. First my presumed gleason was so high that surgery would provide a better "look" as to what was going on. Second for me I felt that surgery was a better option because if things came back i could follow up with radiation. At the time anyway, having surgery post radiation was very difficult because of the tissue damage and virtual vulcanizing of tissue that radiation can cause. So I felt i want a possible second bite of the apple. But again that was me, there is no "right answer" Lets face it success is success and for most all of us as we go on to live normal lives will then feel that our choice was the best.

Remember there is no free ride. You can not go through any treatment with out some kind of effects. Some practically none existent and other pretty rough. But the main thing is to keep kicking.
For me it was sort of the most common ones. incontinence and impotence. Yup the double wammy. Now again there are lots of variables and you can have these issues with any method or not at all. Sometimes that ball lands in the rough.
It has been over 10 years for me, PSA virtually zero. Got my implant, No longer need pads and I still do lots of travel, and adventurous stuff. And don't forget to keep yourself healthy in other ways. Just because you have to deal with this doesn't mean you can slack off on other issues.
good luck and keep us posted on your progress.

Interesting side note. even though I had insurance they claimed that though it was undetectable at the time I got my policy they said it must have been there and thus a pre-existing condition. So I was retroactively uninsured. Gave me back all my premiums minus what they had paid out, and I got $110k in medical bills. Had to go close to 6 years without any insurance. It also put me into bankruptcy. Even the bankruptcy judge couldn't believe that was legal. Yup all 50 states lol. I was able to get on the affordable care insurance for about 9 months before finally making it to medicare, thus the implant :)
But the insurance mafia discussion is for another day.
PC of 10 years. Tried pills, tri-mix, and muse. About to get implanted LGX. Retired S. Florida

Whodat
Posts: 115
Joined: Thu Aug 08, 2019 11:21 pm

Re: PSA Level Up...

Postby Whodat » Sun May 03, 2020 3:46 pm

Fred,
All good advice here. What I understand is that the difference between removing the prostate and radiation is based upon your life expectancy. The longer you expect to live then removal maybe the best. However at age 76 and in good health I chose the radiation as I was advised that I would probably die from something else first. Plus with radiation I didn't have to deal with severe side affects and the agony of surgery.
I had only slight incontinence and bowel issues which went away in a couple of months. My orgasms we're not interfered with and still very intense although almost completely dry. I did explore all the treatment options and concluded that which ever Dr. has as his specialty.... He will try to sell you on that. All boils down to your decision however with your existing health conditions ... I would opt for radiation.
Age 80 good health. Radiation prostate 28 hits 4 years ago with 6 months of horrible ADT. Good recovery and ED worse.
Can't tolerate oral drugs but 5 years of Alprostadil 40mcg/ml 25 units is a miracle for 3 hours. GF is happy!!


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